Information Collection

Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees

IC 35671 under ICR 201505-3245-003 · OMB 3245-0118.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3245-0118 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SBA Form 856 Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees	Form and Instruction
SBA Form 856 Disclosure Statement Leveraged Licensees 3245-0118 SBA Form 856 (5-20-15).docx	Form and Instruction
SBA Form 856 A Disclosure Sstatement Non-LEVERAGED Licensees 3245-0118 SBA Form 856A 5-20-15.docx	Form and Instruction

IC Title:

Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SBA Form 856	Disclosure Statement Leveraged Licensees	3245-0118 SBA Form 856 (5-20-15).docx		No		Paper Only
Form and Instruction	SBA Form 856 A	Disclosure Sstatement Non-LEVERAGED Licensees	3245-0118 SBA Form 856A 5-20-15.docx		No		Paper Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 298

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	298	-2	300
Annual IC Time Burden (Hours)	138	0	138
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.